Fairmile Grange Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the service met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.
 

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People did not always receive person centred care; people and their relatives told us staff were not always there when they needed them.

Staff told us they do not always have relevant information about people to provide person-centred care. Some staff commented this was due to pressure to increase occupancy at the home. A staff member told us, “I understand care planning is important but how can staff focus on this if you have multiple people in active end of life, medication to chase, diary tasks to be completed, unwell residents, assessments and medication rounds during the day? Obviously, paperwork has left behind as the residents have always been our priority.” And, “Recently, we have been pressured to fill the service with people in an unsafe manner. Some weeks we have 3 to 4 admissions a week. Carers are always rushed.”
 

There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Feedback from health and social care professionals highlighted treatment plans and requests of the service for monitoring of people’s health conditions were not always met. Inspectors shared these concerns with the manager who confirmed action was in progress to address issues raised, this included a change to medication administration and further training for staff.
 

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People and their relatives told us information about care and support was available to them. We were assured this service met the requirements of the Accessible Information Standard (AIS). The AIS is a law to make sure that people who have a disability, impairment or sensory loss receive information they can easily read or understand. The provider had presented information to meet people’s individual communication needs, for example, providing documentation and information in different formats such as in pictorial form. This was observed in the service’s lift which had accessible versions of activity schedules and menu choices for people to view.
 

The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

Complaints were not dealt with in an open, transparent, or timely manner and in accordance with the providers policy. People and told us they regularly made complaints and gave feedback to staff but due to inconsistencies within the team, often did not receive a response. Records confirmed the complaints system was managed inconsistently and evidence collected during the inspection showed a lack of the learning being applied following concerns being raised.
 

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

People told us the local doctor’s surgery visited the service weekly and they could ask to see the visiting health and social care professional. However, relatives told us they often had to follow up requests for specialist input to services such as Speech and Language or Physiotherapy. One relative commented, “We chased and chased the service to find out how our loved one was getting on with their new exercises to be told the staff don’t have the time or the capacity, so it hadn’t been started.” Another relative told us, “My relative has equipment to wear alongside a programme of stretching to do but it is often left in their room with no indication they have been encouraged to wear it.”
 

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

A health and social care professional told us, “Sometimes when attending the service, we are given incorrect information by staff. Recently we were told a person wanted active treatment, however upon speaking to their relative and checking their notes they had an end-of-life care plan in place confirming their advance wishes were not to be taken to hospital.” This demonstrated technology used by the service was not always accessible, accurate or easy to use. It was not being used in a way that promoted responsive care and support.

One relative said, “It’s a total mixed bag I’m afraid. Some days I leave the service and think, yes, my relative is well cared for and some days I don’t want to leave.”

The provider and management team were unaware they were supporting people with a learning disabilities and/or autism. Therefore, consideration had not always been made to any specialist support needs or considerations to support people fully in line with nationally recognised evidence-based guidance to design, deliver and review care.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People’s end of life care needs were not assessed regularly or when a person’s health had deteriorated. Support, equipment and medicines were not always provided in good time.

Inspectors were informed of examples of repeated referrals made to safeguarding by relatives and healthcare professionals about people receiving end of life care as there were ongoing concerns. Due to the continued shortfalls in care, considerations had been made whether it was safe for these people to remain at the service.